Phosphodiesterase‐5 inhibition improves bone regeneration at the early stages of ischemic osteonecrosis of the femoral head in rats

2020 ◽  
Author(s):  
André L. Campos Pessoa ◽  
Victor H. V. Oliveira Araújo ◽  
Ana L. Rosa Nascimento ◽  
Nelson Elias ◽  
Jorge J. Carvalho
Keyword(s):  
Femoral Head ◽  
Bone Regeneration ◽  
Early Stages ◽  
Phosphodiesterase 5 ◽  
Ischemic Osteonecrosis

scholarly journals Osteonecrosis of the Femoral Head in Patients with Hypercoagulability—From Pathophysiology to Therapeutic Implications

2021 ◽  
Vol 22 (13) ◽  
pp. 6801
Author(s):  
Elena Rezus ◽  
Bogdan Ionel Tamba ◽  
Minerva Codruta Badescu ◽  
Diana Popescu ◽  
Ioana Bratoiu ◽  
...  
Keyword(s):  
Femoral Head ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Medical Intervention ◽  
Rapid Progression ◽  
Anticoagulant Treatment ◽  
Early Medical Intervention ◽  
Therapeutic Implications ◽  
Early Stages ◽  
Hereditary Thrombophilia

Osteonecrosis of the femoral head (ONFH) is a debilitating disease with major social and economic impacts. It frequently affects relatively young adults and has a predilection for rapid progression to femoral head collapse and end-stage hip arthritis. If not diagnosed and treated properly in the early stages, ONFH has devastating consequences and leads to mandatory total hip arthroplasty. The pathophysiology of non-traumatic ONFH is very complex and not fully understood. While multiple risk factors have been associated with secondary ONFH, there are still many cases in which a clear etiology cannot be established. Recognition of the prothrombotic state as part of the etiopathogeny of primary ONFH provides an opportunity for early medical intervention, with implications for both prophylaxis and therapy aimed at slowing or stopping the progression of the disease. Hereditary thrombophilia and hypofibrinolysis are associated with thrombotic occlusion of bone vessels. Anticoagulant treatment can change the natural course of the disease and improve patients’ quality of life. The present work focused on highlighting the association between hereditary thrombophilia/hypofibrinolysis states and ONFH, emphasizing the importance of identifying this condition. We have also provided strong arguments to support the efficiency and safety of anticoagulant treatment in the early stages of the disease, encouraging etiological diagnosis and prompt therapeutic intervention. In the era of direct oral anticoagulants, new therapeutic options have become available, enabling better long-term compliance.

scholarly journals Tissue Engineering Strategies for Treating Avascular Necrosis of the Femoral Head

2021 ◽  
Vol 8 (12) ◽  
pp. 200
Author(s):  
Sumit Murab ◽  
Teresa Hawk ◽  
Alexander Snyder ◽  
Sydney Herold ◽  
Meghana Totapally ◽  
...  
Keyword(s):  
Tissue Engineering ◽  
Stem Cells ◽  
Femoral Head ◽  
Avascular Necrosis ◽  
Hip Replacement ◽  
Surgical Techniques ◽  
Significant Activity ◽  
X Rays ◽  
Early Stages ◽  
Surgical Methods

Avascular necrosis (AVN) of the femoral head commonly leads to symptomatic osteoarthritis of the hip. In older patients, hip replacement is a viable option that restores the hip biomechanics and improves pain but in pediatric, adolescent, and young adult patients hip replacements impose significant activity limitations and the need for multiple revision surgeries with increasing risk of complication. Early detection of AVN requires a high level of suspicion as diagnostic techniques such as X-rays are not sensitive in the early stages of the disease. There are multiple etiologies that can lead to this disease. In the pediatric and adolescent population, trauma is a commonly recognized cause of AVN. The understanding of the pathophysiology of the disease is limited, adding to the challenge of devising a clinically effective treatment strategy. Surgical techniques to prevent progression of the disease and avoid total hip replacement include core decompression, vascular grafts, and use of bone-marrow derived stem cells with or without adjuncts, such as bisphosphonates and bone morphogenetic protein (BMP), all of which are partially effective only in the very early stages of the disease. Further, these strategies often only improve pain and range of motion in the short-term in some patients and do not predictably prevent progression of the disease. Tissue engineering strategies with the combined use of biomaterials, stem cells and growth factors offer a potential strategy to avoid metallic implants and surgery. Structural, bioactive biomaterial platforms could help in stabilizing the femoral head while inducing osteogenic differentiation to regenerate bone and provide angiogenic cues to concomitantly recover vasculature in the femoral head. Moreover, injectable systems that can be delivered using a minimal invasive procedure and provide mechanical support the collapsing femoral head could potentially alleviate the need for surgical interventions in the future. The present review describes the limitations of existing surgical methods and the recent advances in tissue engineering that are leading in the direction of a clinically effective, translational solution for AVN in future.

scholarly journals Clinical application of injectable growth factor for bone regeneration: a systematic review

2019 ◽  
Vol 39 (1) ◽  
Author(s):  
Yutaka Kuroda ◽  
Toshiyuki Kawai ◽  
Koji Goto ◽  
Shuichi Matsuda
Keyword(s):  
Growth Factors ◽  
Growth Factor ◽  
Femoral Head ◽  
Bone Regeneration ◽  
Clinical Application ◽  
Present Report ◽  
Basic Research ◽  
Limb Ischemia ◽  
Efficacy And Safety ◽  
Gelatin Hydrogel

Abstract Bone regeneration has been the ultimate goal in the field of bone and joint medicine and has been evaluated through various basic research studies to date. Translational research of regenerative medicine has focused on three primary approaches, which are expected to increase in popularity: cell therapy, proteins, and artificial materials. Among these, the local injection of a gelatin hydrogel impregnated with the protein fibroblast growth factor (FGF)-2 is a biomaterial technique that has been developed in Japan. We have previously reported the efficacy of gelatin hydrogel containing injectable FGF-2 for the regenerative treatment of osteonecrosis of the femoral head. Injectable growth factors will probably be developed in the future and gain popularity as a medical approach in various fields as well as orthopedics. Several clinical trials have already been conducted and have focused on this technique, reporting its efficacy and safety. To date, reports of the clinical application of FGF-2 in revascularization for critical limb ischemia, treatment of periodontal disease, early bone union for lower limb fracture and knee osteotomy, and bone regeneration for osteonecrosis of the femoral head have been based on basic research conducted in Japan. In the present report, we present an extensive review of clinical applications using injectable growth factors and discuss the associated efficacy and safety of their administration.

The Percentage of Migration as Indicator of Femoral Head Position

1988 ◽  
Vol 29 (3) ◽  
pp. 363-366 ◽  
Author(s):  
O. Eklöf ◽  
H. Ringertz ◽  
L. Samuelsson
Keyword(s):  
Femoral Head ◽  
Head Position ◽  
Pediatric Age ◽  
Reliable Technique ◽  
Early Stages

In childhood subluxation of one or both hips may develop rather insidiously. For lack of generally accepted objective methods of assessment, ambiguous interpretations of findings in serial examinations are common. Many subluxations are overlooked during the early stages. In order to overcome such disadvantages, determination of the percentage of migration seems to be a reasonably easy and reliable technique facilitating evaluation of impending dislocation. This investigation was carried out in order to establish norms applicable to patients in the pediatric age interval. The 98th percentile of migration increases with age from 16 per cent in patients <4 years of age to 24 per cent in patients ≥12 years. Higher figures represent subluxation. If the migration exceeds 80 per cent a manifest luxation is present. A difference in migration between the two hips larger than 12 per cent indicates abnormality calling for clinical and radiologic follow-up.

Adipose-Derived Stem Cells Enhance Bone Regeneration in Vascular Necrosis of the Femoral Head in the Rabbit

2011 ◽  
Vol 39 (5) ◽  
pp. 1852-1860 ◽  
Author(s):  
A Abudusaimi ◽  
Y Aihemaitijiang ◽  
Y-H Wang ◽  
L Cui ◽  
S Maimaitiming ◽  
...  
Keyword(s):  
Stem Cells ◽  
Femoral Head ◽  
Bone Regeneration ◽  
Adipose Derived Stem Cells

scholarly journals Material properties of bone in the femoral head treated with ibandronate and BMP-2 following ischemic osteonecrosis

2016 ◽  
Vol 35 (7) ◽  
pp. 1453-1460 ◽  
Author(s):  
Olumide O. Aruwajoye ◽  
Pranesh B. Aswath ◽  
Harry K. W. Kim
Keyword(s):  
Femoral Head ◽  
Material Properties ◽  
Ischemic Osteonecrosis
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